[0001] The invention relates to a guiding catheter for angioplasty, substantially consisting
of a hollow tube (lumen) of flexible torsion-stiff material, onto an end of which
connects a tubular extension of flexible material, which is curved according to predetermined
varying radii of curvature, and the free end portion of which is provided with a softer
material than the flexible material.
[0002] The known catheters of the type described in the preamble are used as guiding members
during heart catheterization, wherein the relatively wide hollow tube is guided along
a previously inserted wire. The tube therefore has to be both flexible and torsion-stiff
in order to steer the free end in the aorta and the blood vessels connecting thereto
such that the correct entrance, for instance ostium, is found. To this end the tubular
extension is also curved according to predetermined radii of curvature in order to
be able to reach the correct entrance of the blood vessel. The soft end portion serves
to prevent damage to the wall of the aorta or the blood vessel. With the known catheters,
holding the end portion in the correct position at the transition between the aorta
and the blood vessel, as said ostium, remains a problem because of for instance the
great speed of the blood flow and reactive forces due to the introduction of the balloon
catheter or any other catheter. While it is true that the curved tubular extension
is supported against the wall of the extension, the flexibility of this extension
and the soft end portion nevertheless causes a continuously accurate position difficult
to maintain.
[0003] The invention has for its object to obviate the above mentioned drawback and provides
for that purpose a guiding catheter which is distinguished in that the end portion
of softer material is provided with at least three radially protruding elements.
[0004] These three radially protruding elements ensure a a-traumatic centering of the soft
end portion in the blood vessel in particular said ostium, whereby this end portion
remains better in position, while due to the distance creating working the free passage
of the blood is hardly or not at all obstructed. It is necessary that a continuous
blood flow has to be maintained around the catheter in order to supply blood to the
heart vessels.
[0005] In a preferred embodiment the radially protruding elements are embodied as ridge-shaped
parts extending in axial direction of the catheter, preferably having an arc-like
outer curvature seen in tangential direction. A very great stability of the end portion
of softer material is herewith achieved.
[0006] According to a further development of the invention it is recommended to support
the inside of the end portion of softer material by a narrowed tubular portion of
the extension, whereby the lengthwise stability of the end portion is improved.
[0007] In order to further the pliability of the protruding elements or ridge-shaped parts
in inward sense, it is advantageous according to the invention to embody this narrowed
tubular portion of the extension with passages at the location of the protruding elements.
[0008] Due to these passages the protruding elements can be pressed inward; so insertion
of the catheter through a punction sheath, according the Seldinger technique is still
possible, without enlarging the inner diameter of the punction sheath.
[0009] Above mentioned and other features of the invention will be further elucidated in
the figure description hereinafter of a number of embodiments. In the drawing:
Fig. 1 shows a perspective view of a patient provided with a catheter according to
the invention,
fig. 2 shows a large detail of the aorta with a catheter according to the invention
arranged therein,
fig. 3 and fig. 4 show respectively a lengthwise and a transverse section of the extremity
of the catheter from fig. 2 according to a first embodiment,
fig. 5 shows a perspective view of the centering of the embodiment of fig. 3 in a
blood vessel according to a perspective view,
fig. 6 is a detail of the wall of the end portion of the catheter from fig. 3 in a
different position of the protruding element,
fig. 7 shows a perspective view, corresponding with that of fig. 5, of an alternative
embodiment of the end portion of the catheter according to the invention.
[0010] The catheter shown in the figures consists of a hollow tube 1 of flexible torsion-stiff
material, which at the end 3 remote from the hand grip 2 is extended with a tubular
curved portion, the bends of which each display an adapted radius of curvature, see
fig. 2. This curved extended portion 3 is such that it is adapted to the curvature
of the aorta A, whereby it is possible to place the end portion of the extended portion
3 at the entrance of a blood vessel B connecting onto the aorta A. The curved end
portion 3 is carried via an artery in the arm of the patient from fig. 1 to the aorta,
by pushing it up and rotating it such that the positioning at the entrance of the
blood vessel B can take place. Therein the curve of the tubular part 1 as well as
that of portion 3 supports against the side wall of the aorta. This method of positioning
is however still not sufficient to position the end 4, which is further elucidated
hereunder, precisely in the debouchement of the blood vessel, because of the strong
flow to which the blood is subjected there and/or the reactive forces of the introduced
catheters.
[0011] Shown in fig. 3-6 is a first embodiment of the end portion 4 of the catheter 1 from
fig. 1 and 2. The end portion is substantially formed of a sleeve-like part 5 of soft
material, which gives sufficiently as the catheter is pushed through the artery, so
that no damage occurs to the wall thereof. The soft material 5 is supported on the
inner side by the hollow tubular portion 6 which is more narrowed in circumference
at 7.
[0012] The soft material of the end portion 5 is thickened radially outward at 8 such that
ridge-shaped elements 9 are created which display a determined length. The ridge-shaped,
radially protruding elements 9 end at a distance from the free end of the end portion
5.
[0013] According to a feature of the invention the more narrowed portion 7 of the tubular
extension piece 6 is provided with a passage opening 10 close to the radially protruding
elements 9, whereby it is possible for the radially protruding element 9 to be able
to give inwardly through this opening 10, should this appear to be necessary during
the passage of the catheter in a blood vessel or during insertion into a punction
sheath, see fig. 6.
[0014] The above mentioned embodiment has the following result.
[0015] If the end portion with the protruding elements 9 is carried into the debouchement
of the blood vessel B, see fig. 5, with a correct choice of catheter the outer periphery
of the protruding elements 9 will rest against the inner wall of the blood vessel
B, whereby the end portion comes to lie accurately centered in the blood vessel B.
With this embodiment it is not only possible to accurately centre and position the
end portion, but also to ensure the necessary through-flow of blood. The catheter
can nevertheless be used for feeding all usual substances and to inject contrast fluid
and such like.
[0016] Fig. 7 shows an alternative embodiment, wherein the ridge-shaped protrusions are
formed by an end portion that is star-shaped in cross section and exhibits a large
number of parallel ribs 11 distributed regularly over the periphery.
[0017] It is finally noted that past the passage opening 10 in fig. 3 the end portion 6
can have a ring 12 that is observable with X-rays, whereby the position of the end
portion during the operation can be accurately determined.
[0018] Such a ring 12 can likewise be used with the end portion 4 in fig. 7, for which purpose
this ring can either be circular or can likewise display a star-shaped form similar
to the cross section of the end portion.
[0019] Other embodiments are of course possible within the scope of the invention.
[0020] The ridge-like rib 9 can for instance be subdivided into more, successive protruding
elements, whereby an interrupted ridge results. This can be an advantage for assisting
the blood flow.
[0021] The narrowed part 7 can extend beyond the soft tip end, as a-traumatic insertion
is still possible due to the ridges extending radially.
1. Catheter for angioplasty, substantially consisting of a hollow tube (lumen) of flexible
torsion-stiff material, onto one end of which connects a tubular extension of flexible
material which is curved according to predetermined varying radii of curvature, and
the free end portion of which is provided with a softer material than the flexible
material, characterized in that said end portion of softer material is provided with at least three radially protruding
elements.
2. Catheter as claimed in claim 1, characterized in that the or each radially protruding element is given a ridge-like form.
3. Catheter as claimed in claim 2, characterized in that said ridge-like element has an arc-like outer curvature seen in tangential direction.
4. Catheter as claimed in claim 1 or 3, characterized in that each protruding element ends at a distance from the end opening of the end portion
of the catheter.
5. Catheter as claimed in any of the preceding claims, characterized in that the inner side of the end portion is supported by a narrowed portion of the tubular
extension.
6. Catheter as claimed in claim 5, characterized in that the extension is provided in each case with a passage opening at the location of
the radially protruding elements.
7. Catheter as claimed in any of the preceding claims, characterized in that an annular element observable by X-rays is embedded in the end portion, preferably
between the outflow opening and the end of the radially protruding element.